Does Food Addiction Really Exist?

When people use heroin, their brains become physiologically dependent on the drug and the behavioral patterns of use become written alongside this need. That’s addiction: both behaviorally and biologically, heroin addicts need the drug. When they don’t get it, they crave it, even though they may no longer like it and know the drug is bad for them. If the drug is withheld long enough, the addict experiences symptoms of withdrawal.

Now, an important review of food addiction in the Journal of Nutritionpoints out many parallels between heroin and food. First, drugs and food make us feel good in the same ways – we tend to think about drug addiction first and then wonder how food addiction might be like it, but, really, drugs take over reward pathways in the brain that were originally built for food. The high you get from a drug takes over a system in your brain that, way back in evolutionary time, made you leave your cave to look for vittles. And cravings for drugs are extreme versions of the feelings of hunger and satisfaction that come from eating.

Here’s a little more about how it works: As you probably know, drugs like cocaine create dopamine release in the brain – the longer you use the drug, the less sensitive your brain is to it, and so the more cocaine you need to create dopamine release. The same dopamine desensitization is true in obese people – food creates dopamine release in the brain, but people who chronically overeat require more and more food to create the same “good feeling” of dopamine release.

There’s another critical point in the definition of drug addiction: addicts continue to crave the substance long after they report liking it. With food, most of the foods “addicted” people crave are also foods they like...and continue to like. People who consider themselves food addicts are more likely to crave cake than cucumbers. But there are some exceptions: a study that put people on a bland, vanilla food replacement shake found that in the week after the study ended, some people reported craving the shake even though they also said they didn’t like it – making people accustomed to the “drug” and then taking it away produced cravings even when, like heroin for most long-term addicts, they no longer liked the drug.

So, according to the Journal of Nutrition review, here’s what we know: “Two of the criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders are tolerance and withdrawal and there is evidence for food withdrawal and tolerance.”

Another important criteria for addiction is consequences; part of the definition of drug or alcohol addiction is the negative consequences of this addiction. What are the negative consequences of food? The review points out a critical distinction: for healthy, normal-weight people, the consequences of food are generally positive; for obese people or people who control weight through unhealthy means like bulimia, the consequences of food can be negative, up to and including early death, just as with drug addiction.

“Just as some individuals can drink alcohol responsibly and others cannot, there are individual differences in reactions to food (due to genetic predisposition or to prior experience) and some people can consume food in moderation more easily than others,” the review writes.

In other words, food may be just like alcohol; for people who are addicted, the substances are “addictive”; for people who are not addicted, because the substances don’t really do harm, they are not “addictive”.

So you want to know if food is addictive? Here’s what the review says: “overweight or obese individuals probably do meet the clinical criterion for food addiction, [for example] persistent desire or repeated unsuccessful attempts to quit; important social, occupational, or recreational activities given up or reduced; continued use despite knowledge of adverse consequences.”

If you crave food even past liking it, become desensitized to consumption so that you need more and more to get the same good feeling, and are past a tipping point at which eating has the potential to do real harm, you very well may be addicted to food.

It's all too easy for some people to dismiss food addiction as inauthentic. But I know from experience how real food addiction is.

I've seen teenage girls sell their bodies to get a nickle bag of Doritos. I've seen boys become hustlers, just to get a fix at Krispy Kreme. I myself lived in a cardboard box on the street for weeks, where I spent all my time and money mainlining Cheez Whiz into my veins.

Learn more by reading my autobiography, "The Man With the Golden Arches."

Should a person with an active addiction have any part in the treatment of addicts? In the food realm, that would mean that an overweight addiction specialist should not participate in the treatment of any kind of addicts. How do you determine who is a food addict and who is just fat?

Thank you for this timely article. There are likely to be debates as to whether or not an individual can be addicted to food. Instead of joining the debate, I prefer to share a solution I have found which works. I am a member of Overeaters Anonymous, a 12 Step program of recovery for people who self-identify as having a problem with food. Here is our website: www.oa.org.

I entered OA weighing 240 lbs, which did not reflect my history with bulimia and anorexia. I have now been in OA for 7 and a half years, and have maintained a healthy body weight for over 5 years (I am even part of the National Weight Loss Registry). I encourage you to go to the website, and explore for yourself. Regardless of what you call yourself, if you have a problem with food (physical or simply mental) you are welcome in OA. We're happy to have you join us.

Somewhere in the mix of addiction, compulsion and choice are many behaviors. Thirty years ago, we might have been having this same conversation about gambling. Now there are few people in the field who would discount gambling addiction. Like any new field, our understanding of food addiction is still evolving. But I don't think it's fair to discount it until we know more.